Parathyroid hyperplasia is the enlargement of all four parathyroid glands. The parathyroid glands are glands in the neck that produce parathyroid hormone (PTH).
Parathyroid hyperplasia may occur in people without a family history of the disease, or as part of three inherited syndromes:
In people with an inherited syndrome, a changed (mutated) gene is passed down through the family. You only need to get the gene from one parent to develop the condition.
Symptoms may include:
Blood tests will be done to check calcium, phosphorus, magnesium, PTH, and vitamin D levels. A 24-hour urine test may be done to determine how much calcium is being removed from the body and is leaking into the urine.
Bone x-rays and a bone density test (DXA) can help detect fractures, bone loss, and bone softening.
Surgery is the preferred treatment. Usually 3 1/2 glands are removed. The remaining tissue may be implanted in the forearm so a doctor can easily operate on it if symptoms come back. This tissue will also help the body control calcium levels.
Increased calcium levels persist or return about 20% of the time after surgery.
Parathyroid hyperplasia can cause hyperparathyroidism, which leads to an increase in blood calcium levels.
Patients may also have complications from the other tumors that are part of the multiple endocrine neoplasia syndromes. See also:
Call your health care provider if:
Patients with a family history of the MEN syndromes may want to have genetic screening to check for the defective gene. Those who have the defective gene may have routine screening tests to detect any early symptoms.
Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap. 266.
Bringhurst FR, Demay MB, Kronenberg HM. Disorders of mineral metabolism. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap. 27.
Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 253.